50 Years Ago Today, LBJ Signed Legislation Creating These Historic Programs
Today is the 50th Anniversary of Medicare and Medicaid. As we celebrate the landmark laws that changed the face of American health care, we also look back on the ideological opposition to those programs before their passage. The intensity of the debate surrounding the passage of the Social Security Amendments of 1965 is evocative of similar extreme language surrounding the signing and implementation of the Affordable Care Act.
In the early 1960s President Lyndon Johnson was met with heavy resistance in his attempts to push through the legislation that would eventually go on to provide health insurance to one-third of the American population. The calls to keep the government out of healthcare were fervent. Future President George H. W. Bush called the proposal “socialized medicine,” and Ronald Reagan was famously recorded proclaiming the passage of Medicare would lead to Americans of the future having to tell “our children and our children’s children what it once was like in America when men were free.”
But despite the rhetoric, today Medicare and Medicaid are largely successful programs. Together they provide health insurance to over 100 million Americans, and their provisions have led to innovations in health care delivery and cost control. Both have seen growth and expansion under Republican and Democratic cycles alike, as it became increasingly clear that the effective provision of health care access made them publicly popular and politically intractable.
Opponents haven’t given up the fight to keep the government out of health care, they have just changed their tactics. In the 1990s former Rep. Newt Gingrich was quoted discussing changes that would allow Medicare “to wither on the vine” as opposed to a sweeping removal. And current Chairman of the House budget Committee Paul Ryan has included provisions to privatize Medicare in several budget proposals.
The ACA, as we know, has faced backlash much like Medicare and Medicaid. Opponents have bashed the law with zeal, House Republicans have voted to repeal it more than 50 times, and conservatives have failed to dismantle the law through the courts multiple times. But it too is working. The ACA’s coverage provisions have expanded health care to 16.4 million Americans, the largest increase since the original passage of Medicare and Medicaid. And slowly, public opinion on the law is improving too.
BOTTOM LINE: After initially facing heavy resistance, Medicare and Medicaid have flourished to become essential pieces of health care in America. In much the same way, the political conversation surrounding the ACA must move beyond repeal and turn toward serious debates about how to improve and shape health care for future generations. It is now clearer than ever that the Affordable Care Act is here to stay. (CAP, 6/30/15)